Crew Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Names of crew members

• Foreman:

  Sign

• Crew

  Yes

  No

  N/A

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

• Add signature

  Sign

Description of work being performed

• Comments:

  Yes

  No

  N/A

Duties and Training

• Used proper PPE

  Safe

  At Risk

  N/A

• Documented Tailgate

  Safe

  At Risk

  N/A

• Employee in charge

  Yes

  No

  N/A

• Qualified Employee doing work

  Safe

  At Risk

  N/A

Pre-plan

• One call notified

  Safe

  At Risk

  N/A

• Comments

• Adequate number of crew

  Yes

  No

  N/A

• Jewelry removed

  Safe

  At Risk

  N/A

• Proper clothing

  Yes

  No

  N/A

• Member permission sought

  Yes

  No

  N/A

Approach distance

• PPE worn when inside the approach distance

  Yes

  No

  N/A

• Observer was watching

  Yes

  No

  N/A

• Trucks were grounded

  Safe

  At Risk

  N/A

Rubber gloves

• Proper class of glove worn

  Yes

  No

  N/A

• Protectors in good condition

  Safe

  At Risk

  N/A

• Test date ok

  Safe

  At Risk

  N/A

• Select date

  Date

• Stored properly

  Yes

  No

  N/A

Rubber sleeves

• Proper class of sleeve worn

  Safe

  At Risk

  N/A

• Test date OK

  Safe

  At Risk

  N/A

• Select date

  Date

• Stored properly

  Safe

  At Risk

  N/A

Hard hats

• Clean

  Safe

  At Risk

  N/A

• Worn correctly

  Safe

  At Risk

  N/A

Eye and face

• Proper selection

  Yes

  No

  N/A

• Side shields

  Yes

  No

  N/A

• Worn

  Safe

  At Risk

  N/A

Hearing protection

• Worn

  Safe

  At Risk

  N/A

• Decibel reading from smart phone app

  Safe

  At Risk

  N/A

• Clean

  Safe

  At Risk

  N/A

• Stored properly

  Safe

  At Risk

  N/A

De-Energization of lines

• Proper disconnection

  Safe

  At Risk

  N/A

• Proper tag and or lockout

  Safe

  At Risk

  N/A

• Tested for absence of voltage

  Yes

  No

  N/A

• Grounded properly

  Yes

  No

  N/A

• One person in charge of clearance

  Safe

  At Risk

  N/A

• Conductor cleaned before being grounded

  Yes

  No

  N/A

• Test date on grounds

  Safe

  At Risk

  N/A

• Select date

  Date

• Grounds installed with hot stick

  Yes

  No

  N/A

• Running grounds used

  Safe

  At Risk

  N/A

• Proper communication used

  Safe

  At Risk

  N/A

Neutrals

• Bridged before opening

  Safe

  At Risk

  N/A

Hot sticks

• Current test date

  Yes

  No

  N/A

• Select date

  Date

• Proper length

  Yes

  No

  N/A

• Clean

  Safe

  At Risk

  N/A

• Stored properly

  Safe

  At Risk

  N/A

Climbing

• Employee certified as climber

  Safe

  At Risk

  N/A

• Inspected tools before climbing

  Safe

  At Risk

  N/A

• Sharps on hooks guarded

  Safe

  At Risk

  N/A

• Long sleeve shirt worn while climbing

  Safe

  At Risk

  N/A

• Hand line used

  Yes

  No

  N/A

Equipment and tools

• Cords in good condition

  Safe

  At Risk

  N/A

• Hoses in good condition

  Safe

  At Risk

  N/A

• Ropes in good condition

  Safe

  At Risk

  N/A

• Slings in good condition

  Safe

  At Risk

  N/A

Poles

• Hauled properly

  on trailer

  side of truck

  already on site

• Gloves worn while handling

  Safe

  At Risk

  N/A

• Proper cover-up when setting

  Safe

  At Risk

  N/A

Vehicles

• Daily inspection done

  Yes

  No

  N/A

• Seat belts used

  Yes

  No

  N/A

• Clean cab

  Yes

  No

  N/A

• Grounded when needed

  Yes

  No

  N/A

• Ground connections and clamps approved

  Safe

  At Risk

  N/A

• Wheel chocks used

  Safe

  At Risk

  N/A

• Back up alarms working

  Yes

  No

  N/A

• Outrigger pads used

  Safe

  At Risk

  N/A

Traffic control

• Signs used

  Yes

  No

  N/A

• Cones used properly

  Yes

  No

  N/A

• Flagger used when needed

  Yes

  No

  N/A

• Vest worn

  Yes

  No

  N/A

• Proper flagging equipment

  Yes

  No

  N/A

• Flagging done properly

  Yes

  No

  N/A

• Proper size cones

  Yes

  No

  N/A

• Proper size signs

  Yes

  No

  N/A

• Four way flashers used

  Yes

  No

  N/A

• Strobe/Rotating light in use

  Yes

  No

  N/A

Tree trimming

• Chainsaw properly adjusted at idle

  Yes

  No

  N/A

• PPE used chemical application

  Safe

  At Risk

  N/A

• Sprayers labeled properly

  Yes

  No

  N/A

• Chaps worn

  Yes

  No

  N/A

• Hearing protection worn

  Safe

  At Risk

  N/A

• Employees clear of hazard work area

  Safe

  At Risk

  N/A

• Eye protection worn

  Safe

  At Risk

  N/A

• Hard hats worn

  Yes

  No

  N/A

• Rubber gloves worn when needed

  Safe

  At Risk

  N/A

• Employee tied in when in tree

  Yes

  No

  N/A

• Ropes in good condition

  Yes

  No

  N/A

• Cables in good condition

  Yes

  No

  N/A

Aerial Device

• Grounded when needed

  Safe

  At Risk

  N/A

• Proper fall protection worn

  Yes

  No

  N/A

• 8' of fiberglass out when needed

  Safe

  At Risk

  N/A

• Controls marked

  Safe

  At Risk

  N/A

• Chocked when needed

  Yes

  No

  N/A

• Boom cleaned and waxed

  Yes

  No

  N/A

• Pre-flight of controls done

  Yes

  No

  N/A

• Dielectric test done

  Yes

  No

  N/A

• Select date

  Date

• Outrigger pads used

  Yes

  No

  N/A

Energized conductor work

• Proper cover-up

  Safe

  At Risk

  N/A

• Used proper amount of cover-up

  Yes

  No

  N/A

• Weather conditions OK

  Safe

  At Risk

  N/A

• Proper PPE

  Safe

  At Risk

  N/A

• Observer watching

  Yes

  No

  N/A

URD Work

• Adequate trench protection

  Safe

  At Risk

  N/A

• Means of egress in trench

  Yes

  No

  N/A

• Competent person on job site

  Yes

  No

  N/A

• Spoils 2ft from trench

  Yes

  No

  N/A

• Cables spiked before cutting

  Yes

  No

  N/A

• Proper grounding

  Safe

  At Risk

  N/A

• Proper lock/tag out

  Safe

  At Risk

  N/A

• Proper signage on cabinets

  Yes

  No

  N/A

• Cabinets locked

  Safe

  At Risk

  N/A

Comments: